The Patient Companion in the Consultation of Family Medical Practice is an Indicator of Hidden Family Problems

Abstract

Objective: Analyze the hypothesis that exposure to family problems results in the presence of a patient companion in the medical consultation. Material and method: This is a retrospective study of cases and controls. "Case" was defined as a patient with a companion, and "control" as a patient without an accompanying adult. Problems in the family context (based on the genogram) were considered the previous exposure factor. For each case, the patient with the next appointment in the practice who did not come with a companion was chosen as a control. For each patient, the following variables among others were collected: age, sex, chronic diseases, medications, and social class. The bivariate comparisons were performed using the Chi square test, the Student t test, and the Mann-Whitney test. Finally, an analysis using logistical regression was performed. Results: 106 cases and 106 controls were obtained. The cases had more problems in the family context (45.1% vs. 30%; p = 0.03). Significant differences were found in favor of the cases in the following variables: older (≥ 65 years: 38.7% vs. 19.8%), a higher average number of chronic diseases (2.39 vs. 1.92); more drugs prescribed (2.96 vs. 1.97), and lower social class. When the logistical regression analysis was conducted on the variables that showed statistical significance in the bivariate analysis, using as the dependent variable the problems in the family context of the patient, significant differences were found only in the total number of chronic diseases (p = 0.019; OR = 1.384; risk factor), and age (p = 0.024; OR = 0.977; protection factor). Conclusion: The presence of a patient companion in the consulting room is an indicator of problems in the family context, and should be used as a signal to investigate psychosocial family data.